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No the studies conclude the reverse, an HIV+ person with VL=UD has at most 4% chance (possibly 0%) of transmitting the virus to others. I don't think it correlates to the risk of receiving a different strain of virus (say from a recently seroconverted, highly infectious, super ignorant barebacker). But it should be possible to conclude that two HIV+ persons with VL=UD have no chance of transmitting their own strains of HIV to each other.

*PS: Before the flame war starts, 'ignorant' refers to 'not knowing one's HIV status', NOT 'not knowing the risks associated with barebacking..'

I think you have your logic backwards... Just because an UD seems not to pass the virus to others, doesn't mean he's immune to receiving HIV from someone with a high viral load.

I think all the super virus cross infection stuff has been shown to be bunk, and your meds would likely suppress anything new thrown into the mix.

Maybe someone with more knowledge into the research would know if strains resistant to your meds could be a problem and get into your reservoirs, but since people aren't dropping dead left and right from some super AIDS resistant to everything, I tend to doubt it is a big concern.

i recall reading that in 'some people' viral load is transitory and detectable in semen (although relatively low) while an STD is present in their urinary tract despite being UD in plasma.

however despite a detectable viral load in semen i still have not read anywhere that this will mean a possible hiv transmission.....maybe cause the viral load in semen in these people is relatively low?

"No the studies conclude the reverse, an HIV+ person with VL=UD has at most 4% chance (possibly 0%) of transmitting the virus to others."

Doesn't the 2 year PARTNER story debunk that 4% statement?? I am led to believe that it is a 0 {zero} percent chance of passing HIV to a HIV- person if my VL is UD...

No, the PARTNER study is where the max 4% transmission per year for receptive condomless sex comes from. This was based on the PARTNER data extrapolated to a high confidence level. Basically, there isn't enough data to say absolutely 0% risk, and it's unlikely they'll ever say it's absolutely impossible.

"No, the PARTNER study is where the max 4% transmission per year for receptive condomless sex comes from. This was based on the PARTNER data extrapolated to a high confidence level. Basically, there isn't enough data to say absolutely 0% risk, and it's unlikely they'll ever say it's absolutely impossible."

But the 4% was a different strain genetically and 38% acknowledged anal sex outside of the relationship thus deducing that the 4% were infected outside the relationship

"No, the PARTNER study is where the max 4% transmission per year for receptive condomless sex comes from. This was based on the PARTNER data extrapolated to a high confidence level. Basically, there isn't enough data to say absolutely 0% risk, and it's unlikely they'll ever say it's absolutely impossible."

But the 4% was a different strain genetically and 38% acknowledged anal sex outside of the relationship thus deducing that the 4% were infected outside the relationship

Is it worth taking the chance of infecting someone else when you know what the hardships are by being infected?

Hi Teddy . Undetectable is only part of the equation when you start using percentages .

For instance a person can have syphilis for a long time and not know and when it awakens all bets are off as how infectious a person is who has been previously undetectable .

Its good that we have these conversations because we would not want a person to think that being undetectable is always the end game in risk prevention .

This is why we advise ... You need to be using condoms for anal or vaginal intercourse, every time, no exceptions until such time as you are in a securely monogamous relationship where you have both tested for ALL sexually transmitted infections together.

...But the 4% was a different strain genetically and 38% acknowledged anal sex outside of the relationship thus deducing that the 4% were infected outside the relationship

They threw out the results of those who picked up HIV outside of the relationship. The theoretical risk we're talking about is still from an UD person to their negative partner in receptive anal sex over the course of a year.

"The main news is that in the PARTNER Study so far there have been no transmissions within couples from a partner with an undetectable viral load, in what was estimated as 16,400 occasions of sex in the gay men and 14,000 in the heterosexuals."

riskPlease read about this newly released study:

AIDSmap: No-one with an undetectable viral load, gay or heterosexual, transmits HIV in first two years of PARTNER study

I think I have perhaps answered my own question...From Dr. Joel Gallant:

"I thought I already explained it pretty well in my recent discussion of the PARTNER study. In that study, there were no transmissions from a positive partner with an undetectable viral load to a negative partner. In HPTN 052 there was one transmission from a positive partner on ART to a negative partner, but the positive partner’s viral load probably hadn’t been fully suppressed at the time of the transmission. Therefore, the results of the two studies are consistent: both suggest that the estimated risk of sexual transmission is zero if the positive partner has an undetectable viral load.

For reasons I already discussed, that’s still an estimated risk. It’s hard to prove a negative. It’s possible that if both studies had been larger, there might have been a transmission. Still, the results of these two studies are highly reassuring."

No, the PARTNER study is where the max 4% transmission per year for receptive condomless sex comes from. This was based on the PARTNER data extrapolated to a high confidence level. Basically, there isn't enough data to say absolutely 0% risk, and it's unlikely they'll ever say it's absolutely impossible.

the whole thing of being reinfected with a different strain, superinfection. just as a question not as any sort of behavior justification.... is that real? i don't mean the "it's possible" sort of answer, does it really happen enough to be a legitimate concern?

An HIV+ UD person does not transmit HIV to another HIV- or HIV+ person (Undetectable is the new "negative" in condomless sex)

An HIV+ UD peron cannot be reinfected or superinfected by another HIV+ person if that other HIV+ person is UD then of course +transmission is 0% if that other HIV+ person has a detectable VL, the UD/medicated status (ie PrEP in fact) of the first person is protection against infection

I suppose it's worth saying this yet again for the sake of our newbies.

For a start, the term "superinfection" is completely interchangeable with the term "reinfection". It's the same darn thing dressed up with a more frightening word.

The term "superinfection" scares a lot of people because it sounds like some kind of super-strength infection, like Superman is a super-strength man. It's not.

The "super" part of the word is a prefix that means 'one on top of the other', as it does in the word superimposed. It's one infection on top of the other - one virus "superimposed" on the other. It's usually a resistance type virus on top of a wild-type virus.

It doesn't mean you'll get sicker quicker or anything like that - it would only mean that you might be resistant to a med or sometimes a whole class of med. If my memory serves, Sustiva was the usual culprit in the RARE few cases in which they'd observed superinfection.

Resistance to Sustiva isn't the end of the world these days, we have many more meds and med classes to chose from today. Inconvenient, yes. Game-changing? Slightly. The-end-is-nigh? NO.

The few cases of reinfection I've read about occurred in people who were very newly infected with their first infection - so early that their body had not yet really got to grips with it - when along comes a slightly different strain of hiv that was therefore able to take hold. And they were NOT on meds!

Someone who has been infected for a while and has plenty of hiv antibodies, and/or someone who is on meds just isn't going to end up reinfected. As someone else in this thread mentioned, if it was a huge problem, there would be many of us in this forum facing it. It's not and there aren't.

In my opinion, it's a bogeyman that some medical professionals like to trot out to keep poz people from going bareback with other poz people. Some med pros don't like us to have sex at all, nevermind unprotected sex. That attitude is changing, albeit slowly.

It would be far more reasonable for them to be truthful - that reinfection is RARE as hen's teeth, but if you're gonna BB with your fellow pozzies, make sure you're not getting a dose of the clap or syphilis. Honesty, ya know? Blunt, brutal, HONESTY. ~sigh~

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

For any HIV negative human on this planet, the future chance of getting HIV in one's lifetime is NOT exactly 0, while alive.

Who knows what bizarre, far-fetched story may happen. Or usual run of the mill story. But one can still get it. Until they're dead.

Ditto to risk of so-called superinfections.

ABOUT RANGES

In epidemiology, populations are studied through samples.

In an ideal world, every single person in the population gets studied over long time periods for something of interest. But that's expensive, time-consuming, and impractical. In the real world, a sample is used to represent the entire population. It also gets studied over much shorter time periods.

Statisticians have come up with ways to extrapolate such information from such samples. Both to the larger general population and to longer time periods.

However, this leads to a possible range of chance. The fabled 95% confidence interval. Not just a single value.

ABOUT THE PARTNER STUDY

So, yes, the PARTNER researchers found 0 transmissions over a median 2.5 years of follow-up. But based on the sample size for each type of sex, their eggheads are 95% confident for condomless sex that the UPPER limit for HIV transmission risk was: